Figure 4.

EUS-guided hepaticogastrostomy for normal anatomy patient with benign biliary stricture. (a) Insertion of duodenoscope was unsuccessful owing to the duodenal stricture results from walled-off necrosis. (b) Endoscopic view of duodenal stricture. (c) Intrahepatic bile duct was punctured with 19G needle. The previously placed biflanged metal stent for walled-off necrosis is recognized in the right side of the image. (d) 0.025-inch guidewire was advanced into the common bile duct. (e) Dedicated plastic stent was placed after the tract dilation